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Ask the doc...
Dr. R. Murlidharan, Consultant Dermatologist, Apollo Hospital, Chennai, answers this week’s queries.
The skin on my back has always been sensitive and dry for over 20 years. However it was manageable by occasional application of moisturisers. But now it has become acute. A dermatologist prescribed Fluticasone cream, to be used once a day for a week. After two or three applications, the itching subsides greatly. Is it okay to use the cream only when the itching is unbearable? S. A. Abbasi
Answer: Regular use of topical steroids on the skin causes thinning and other unwanted side effects. You are using this on large areas of the skin; hence there is a chance of systemic absorption affecting general health. Many may not be aware that chronic use of topical steroid creams actually increases dryness. Look for other causes of dry skin like anaemia, liver disease and thyroid disease. Sometimes kidney disease can also produce dry skin, but since you say you have had dry skin for 20 years, I am discounting that possibility. Use moisturisers everyday. Since the itching has worsened of late, get yourself investigated rather than use a steroid cream blindly.
I have keloids for last six years. Initially they were very small in size as well as in count but have grown in size and multiplied in number. It started in my chest with three different spots close by and by now all these individual spots are grown and connected and it was almost three inches in length with thickness of 0.5cms from my normal skin. What is the solution? Krishnan
Answer: Keloids represent an increased rate of formation of fibre in the skin. This may be spontaneous or after trauma. In some this tendency is inborn and genetic. The chest is a common place for keloids to occur. There are no proven internal medicines for treating keloids as yet. Surgery is not recommended, as they invariably recur. The best treatment is repeated monthly injections of a steroid injection into each keloid. This does not have any side effects if done properly. The improvement can be maintained by a cream. The procedure usually takes a year and is labour-intensive. Another method called cryotherapy is being practised but I personally do not recommend this. Please consult an experienced dermatologist.
I am 20 years old. The skin on the thigh near the testes keeps peeling. I used to scratch very badly since the area would itch terribly. Now even when I don’t scratch also the skin continues to peel off. Is there a solution? Name withheld
Answer: The fold between the testes and the thigh tends to retain sweat, which can damage the skin. This is the commonest cause of itching on the groins. Some patients develop fungal infections there due to constant moisture. See a dermatologist who can examine you, differentiate the two and help you with specific therapy for this. Do not use combination drugs indiscriminatingly.
I am 24. For two years I have been suffering from acne. A month ago I was prescribed T.Azee, Clingard gel for a week. The pimples have gone except a few but dark marks remain. Is there any remedy apart from cosmetic surgery? Preeti
Answer: Cosmetic surgery and surgical interventions in dermatology are not always necessary. Pimples or acne can occur even after the age of 20. The black marks are usually due to a condition called acne hypermelanotic macules. Make sure they are not deep scars. These patches usually disappear with continued treatment. Clindamycin is to be continued for at least two to three months and azithromycin may have to be taken next month also at the same time, especially before your periods, as acne may worsen before the periods. At night I usually recommend a cream that has adapelene. This increases the turnover of the skin and hence clears marks faster. See a dermatologist, as the cream can produce excessive dryness of the skin. Avoiding sunlight, eating more vegetables and avoiding cosmetics are other measure you can use. A light chemical peel will help at a later stage, if the acne does not keep coming back.
I am 67. I am having severe itching due to eczema in my left ankle. Sometimes I scratch till it bleeds. When I scratch initially the skin becomes white and powdery, then it turns red. I have tried creams and ointments but nothing seems to help. Subramanian
Answer: Your problem is twofold: the dry skin due to the location of the eczema and what appears to be a habitual and uncontrollable itching. The dryness itself can stimulate mild itching. However, when you scratch, you tend to damage the skin, which will protect itself by thickening. This will further worsen the irritation. It is vital that you break this cycle by not scratching. Ask your doctor if you can take doxepin; this has to be used under medical supervision. Regular use of moisturisers and a topical mild steroid antibiotic will do the job equally well, provided you do not irritate the skin further. Otherwise, see a dermatologist.
Send your queries to
Ask the Doc, Magazine,
The Hindu,
859-860, Anna Salai,
Chennai 600002. Or e-mail: askthedoc@thehindu.co.in
This space is not meant for personal consultations. Only queries of a general nature on a problem and its treatment will be answered. Please do not send medical reports or prescriptions with your questions. Keep your queries short and focused.
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